New HHS Rule Could Lead to Boost in Medicaid Reimbursements

Medicaid reimbursements may rise for primary care physicians next year due to a recent rule proposed by the U.S. Department of Health and Human Services (HHS). The proposed rule would require Medicaid reimbursements at Medicare levels for family medicine, general internal medicine, pediatric medicine, and related subspecialists during 2013 and 2014.

This proposal is similar to the boost in Medicare payments to primary care physicians in 2011, and aims to ensure that primary care networks are prepared for the expected rise in enrollment resulting from the implementation of the Patient Protection and Affordable Care Act (PPACA). HHS hopes that increased payments will incentivize primary care physicians to expand services over time, ultimately resulting in improved health and lower costs overall. States would receive approximately $11 billion in new funds under the proposed rule, with no matching requirement.